Provider Demographics
NPI:1205218757
Name:PAZUNIAK, MARKIAN YURIY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARKIAN
Middle Name:YURIY
Last Name:PAZUNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 OGLETOWN STANTON RD STE 116
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-4700
Mailing Address - Fax:302-623-7816
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 116
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-4700
Practice Address - Fax:302-623-7816
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT209825390200000X
MDD849242084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD84924OtherMARYLAND BOARD OF MEDICINE
DEC1-0013669OtherMEDICAL LICENSE
PAMT209825OtherPENNSYLVANIA BOARD OF MEDICINE